Pseudogout vs Septic Arthritis
Pseudogout and Septic Arthritis are easy to mix up on the boards. Here's a side-by-side comparison — presentation, workup, imaging, and first-line treatment — drawn from our full outlines.
Pseudogout vs Septic Arthritis at a glance
- Pseudogout: Acute crystal arthritis from calcium pyrophosphate deposition; classic site is the knee with chondrocalcinosis.
- Septic Arthritis: Bacterial infection of a joint — orthopedic emergency requiring urgent arthrocentesis and drainage.
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Side-by-side comparison
| Feature | Pseudogout | Septic Arthritis |
|---|---|---|
| At a glance | Acute crystal arthritis from calcium pyrophosphate deposition; classic site is the knee with chondrocalcinosis. | Bacterial infection of a joint — orthopedic emergency requiring urgent arthrocentesis and drainage. |
| Classic presentation | Acute monoarticular or oligoarticular swelling, pain, and warmth — most often knee or wrist; Onset over hours to a day; often precipitated by surgery, trauma,… | Acute monoarticular pain, swelling, warmth, erythema; Markedly reduced range of motion; Fever, chills (variable — fever absent in up to 40%); Migratory… |
| Workup / key labs | ACR/EULAR 2023 classification criteria for CPPD use clinical features + imaging + crystal identification.; Arthrocentesis with polarized microscopy — rhomboid… | Arthrocentesis BEFORE antibiotics when possible (do not delay antibiotics if patient septic):; • WBC count, differential (typically >50,000 with >75% PMNs;… |
| Imaging | Plain radiographs — linear calcification within hyaline or fibrocartilage (chondrocalcinosis), classically in knee menisci, triangular fibrocartilage complex… | Plain radiographs — baseline; usually unremarkable acutely; soft tissue swelling, joint effusion; Ultrasound — guides aspiration, especially for deep joints… |
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